Fu Chih-Yuan, Wu Shih-Chi, Chen Ray-Jade, Chen Yung-Fang, Wang Yu-Chun, Huang Hung-Chang, Huang Jui-Chien, Lu Chih-Wei, Lin Wei-Ching
Trauma and Emergency Center, China Medical University Hospital, No. 2 Yuh-Der Road, Taichung 404, Taiwan, ROC.
World J Surg. 2010 Nov;34(11):2745-51. doi: 10.1007/s00268-010-0723-x.
Angioembolization is an effective adjunct to the management of blunt splenic injuries (BSI) that are not surgically treated. However, in some cases patients are unable to undergo angioembolization due to changes in their hemodynamic condition. In this study we attempt to define the characteristics of patients who need angioembolization in high-grade BSI.
We retrospectively reviewed the charts of patients with BSI between January 2004 and June 2008. Patients with contrast extravasation (CE) on computed tomography (CT) scan were enrolled. The demographics, Injury Severity Score (ISS), Abbreviated Injury Scale (AIS), the amount of blood transfused, and the type of CE were analyzed.
A total of 69 patients were enrolled. Patients with intraperitoneal CE in BSI required a higher rate of immediate operation due to changed hemodynamics. Furthermore, these patients displayed higher ISS and higher blood transfusion amounts.
In BSI patients, intraperitoneal CE is associated with a higher possibility of requiring surgical intervention. Early surgical intervention should be considered in BSI patients with intraperitoneal CE or with ISS ≥ 25.
血管栓塞术是未接受手术治疗的钝性脾损伤（BSI）治疗的有效辅助手段。然而，在某些情况下，患者由于血流动力学状况的改变而无法接受血管栓塞术。在本研究中，我们试图明确重度BSI患者中需要血管栓塞术的患者特征。
我们回顾性分析了2004年1月至2008年6月期间BSI患者的病历。纳入计算机断层扫描（CT）显示有造影剂外渗（CE）的患者。分析患者的人口统计学数据、损伤严重程度评分（ISS）、简明损伤定级标准（AIS）、输血量以及CE类型。
共纳入69例患者。BSI合并腹腔内CE的患者因血流动力学改变需要立即手术的比例更高。此外，这些患者的ISS更高，输血量也更多。
在BSI患者中，腹腔内CE与更高的手术干预可能性相关。对于合并腹腔内CE或ISS≥25的BSI患者，应考虑早期手术干预。
